The Department of Labor has drafted regulations which provide that a disability claim must be resolved, at the initial level, within 45 days of receipt of a complete application; a plan may, however, extend that decisionmaking period for an additional 30 days for reasons beyond the control of the plan.
If, after extending the time period for a first period of 30 days, the plan administrator determines that it will still be unable, for reasons beyond the control of the plan, to make the decision within the extension period, the plan may extend decisionmaking for a second 30-day period
FAQ / ERISA Information:
Why is ERISA an unfair law for disability insurance claimants?
ERISA stands for the Employer Retirement Income Security Act and it was a Federal law that was passed in the early 1970s which was supposed to make it more affordable for employers to be able to offer long term disability coverage as well as health insurance for employees.
Disability Insurance Attorneys Gregory Dell and Stephen Jessup discuss the numerous reasons that ERISA is an unfair law that can negatively impact the thousands of people that file disability insurance claims each year.
In a recent Federal Court decision in favor of First Unum, the Court validated the right of a long-term disability insurance plans to rely upon functional capacity evaluations (FCE) as a basis for determining whether or not the claimant has the right to continue receiving disability insurance benefits. In VanWright v. First Unum, VanWright’s long-term disability attorney pointed to another case, Alfano v. Unum, as a reason that the Court should not find First Unum Insurance Company’s decision to terminate his client’s disability benefits reasonable. It appears that disability benefits were appropriately terminated in this case as the disability claimant was performing activities that far exceeded the restrictions and limitations indentified by his treating physician. A look into the background of this case will show why the Court took Unum’s side in its decision.